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All Journal Syntax Literate: Jurnal Ilmiah Indonesia Hearty : Jurnal Kesehatan Masyarakat PREPOTIF : Jurnal Kesehatan Masyarakat COMSERVA: Jurnal Penelitian dan Pengabdian Masyarakat Majalah Anestesia & Critical Care (MACC)
Labobar, Otniel Adrians
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Humanities Economics, Econometrics & Finance Education Environmental Science Industrial & Manufacturing Engineering Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Public Health Social Sciences Other

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Journal : Syntax Literate: Jurnal Ilmiah Indonesia

 1 
Lidocaine 2% and Xylocaine Spray as A Combination in Successful Awake Intubation in Difficult Airway: How to Do it? Murti, Dede Taruna Kreisnna; Senapathi, Tjokorda Gde Agung; Pradhana, Adinda Putra; Labobar, Otniel Adrians
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i1.56380

Abstract

Awake intubation is a technique used to insert an endotracheal tube while maintaining the patient's consciousness. It is particularly beneficial for patients with difficult airway anatomy, as it allows better visualization using a fiber optic bronchoscope, reduces discomfort with local anesthesia, and ensures the preservation of spontaneous breathing. This approach is critical in high-risk procedures such as total thyroidectomy. This case report aims to describe the application of awake intubation in a high-risk patient undergoing total thyroidectomy due to a thyroid mass causing tracheal narrowing. A 47-year-old female with airway management difficulties (LEMON 3/10, MOANS 0/5) was scheduled for a 3–4-hour total thyroidectomy. Preoperative preparation included fasting, informed consent, and ensuring complete anesthesia equipment. Airway preparation involved Xylocaine spray and Lidocaine nebulization, followed by premedication with Dexamethasone, Diphenhydramine, and Midazolam. Induction was achieved using Propofol, and intubation was performed with an endotracheal tube guided by a fiber optic bronchoscope. Maintenance of anesthesia utilized Oxygen, Sevoflurane, and Atracurium. The results show the patient tolerated the awake intubation procedure well, with no episodes of desaturation or significant bleeding during surgery. Postoperative management included analgesia with Fentanyl and Ketamine, as well as respiratory therapy intervention (RTI) during recovery. Awake intubation, combined with effective airway preparation and anesthesia protocols, provides a safe and reliable approach for managing patients with difficult airways, particularly in high-risk procedures like total thyroidectomy. The technique ensured patient comfort, maintained oxygenation, and minimized perioperative complications.
Tatalaksana Anestesi Pada Pasien Dengan Severe Aortic Stenosis Dengan Tindakan Hemicolectomy Dextra Putu Diah Virayanti, Luh; Labobar, Otniel Adrians; Ryalino, Christopher; Agung Senapathi, Tjokorda Gede
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i1.56469

Abstract

Pada pasien dengan gangguan katup jantung yang akan dilakukan operasi non kardiak memiliki beberapa potensi masalah selama operasi, sehingga diperlukan pemeriksaan, persiapan dan tatalaksana yang baik. Pasien dengan severe aortic stenosismemiliki permasalahan fixed cardiac output yang berarti cardiac output sangat ditentukan oleh laju jantung. Pemilihan modalitas anestesi sangat penting dilakukan untuk menjaga respons simpatis sehingga tidak terjadi takikardia ataupun bradikardia pada pasien dengan severe aortic stenosis. Pemilihan teknik anestesi, termasuk penghindaran neuroaxial anesthesia, serta penggunaan epidural untuk analgesi dan pemantauan yang cermat terhadap tekanan intratorakal saat ekstubasi. Pada pasien ini dilakukan anestesi umum dengan Midazolam, remifentanyl TCI Mode Minto target effect 3 – 4 mcg/ml, Rocuronium 30 mg IV, dan pemeliharaan dengan udara: O2: sevoflurane. Pemasangan epidural setinggi L2-L3, target tip T10, kateter masuk 6 cm di dalam ruang epidural, target dermatom T6-T10, target viscerotom T6-L2. Dilanjutkan dengan pemberian regimen Bupivacaine 0,0625% plain 10 ml sebagai agen analgesia. Selain itu dilakukan pemasangan akses vena sentral untuk mengetahui volume vena sentral, akses obat dan nutrisi parenteral paska operasi. Durante pasien stabil, dan dilakukan ekstubasi paska operasi dengan agen reversal berupa neostigmine dan sulfas atropine. Pasien dirawat diruang intensif paska operasi selama 2 hari.
Airway Management Using Awake Fiberoptic in Thyroid Tumors: Case Report Labobar, Otniel Adrians; Ratumasa, Marilaeta Cindryani Ra; Aryasa, Tjahya; Irawan, Ferry
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i2.57740

Abstract

This case report aims to evaluate the effectiveness of the awake fiberoptic intubation (AFOI) technique in airway management for a patient with a thyroid mass. This is a descriptive case report that provides a detailed account of airway management in a patient with a thyroid mass. The subject of this study is a 47-year-old female with a thyroid mass. Data were collected through history-taking, physical examination, radiographic evaluation, and assessment using criteria such as MOANS, LEMON, and RODS to identify potential airway challenges. Anesthetic management and the intubation process were meticulously documented during surgery, including vital signs, drug administration, and the intubation procedure. The data were then presented in a narrative format, supported by preoperative clinical images, radiographic evaluation, and intraoperative monitoring. The results indicate that various airway assessment tests can predict difficult airway scenarios, and this case was successfully managed following ASA guidelines. The AFOI technique, which includes premedication, local anesthesia, and sedation, demonstrated a high success rate with minimal complications. In this case, AFOI was successfully performed via the oral route, with the patient remaining calm, awake, and cooperative throughout the procedure.
Co-Authors Adinda Putra Pradhana Agung Senapathi, Tjokorda Gede Christopher Ryalino EM, Tjahya Aryasa Ferry Irawan Ferry, Ferdinand Fikrawan, Putu Filla Jaya I Gusti Agung Gede Utara Hartawan Murti, Dede Taruna Kreisnna Pontisomaya Parami Putu Diah Virayanti, Luh Ra Ratumasa, Marilaeta Cindryani Ratumasa, Marilaeta Cindryani Ra Sidabutar, Beny Pratama Tjahya Aryasa Tjokorda Gde Agung Senapathi Wirahadi, Dhanu Enggar